Intra-session stability of short-term heart rate variability measurement: Gender and total spectral power influence

Lukas Cipryan, Martina Litschmannova

Abstract

Purpose: Heart rate variability (HRV) has been increasingly analysed under numerous research settings. HRV measurement reliability is, however, still an unresolved issue. The main purpose is to carry out an intra-session stability evaluation of HRV parameters from short-term recordings by means of orthoclinostatic stimulation in a study group which is stratified by gender or Total Power (PT) magnitude. The goal is to make as homogeneous a study group as possible and investigate whether the reproducibility level could be influenced by these factors. Methods: The study group consisted of 103 participants (age 22.3 ± 1.2). Standard HRV indexes were computed: PT (total spectral power), PHF (high frequency spectral power), PLF (low frequency spectral power) and LF/HF. Absolute reliability is assessed by the standard error of measurement and 95% limits of agreement; the relative reliability is assessed by the intraclass correlation coefficient. Results: The markedly different standard error of measurement (SEM) between the Male and Female groups was not observed for any HRV parameters. The intraclass correlation coefficient (ICC) values ranged from 0.67 to 0.95 for males and from 0.69 to 0.97 for females. According to the SEM and ICC, there is no difference between the groups of High PT and Low PT. Conclusion: There are not any significant differences in absolute or relative reliability between the more homogeneous study groups and we have therefore concluded that HRV measurement reliability is not influenced by gender or HRV magnitude.


Keywords

Heart rate variability; Reliability; Autonomic nervous system; Test-Retest; Orthoclinostatic

References

ANTELMI I, DE PAULA RS, SHINZATO AR, PERES CA, MANSUR AJ, GRUPI CJ. Influence of age, gender, body mass index, and functional capacity on heart rate variability in a cohort of subjects without heart disease. Am J Cardiol. 2004; 93:381-385. https://doi.org/10.1016/j.amjcard.2003.09.065

ATKINSON G, NEVILL AM. Statistical methods for assessing measurement error (reliability) in variables relevant to sport medicine. Sports Med. 1998; 26:217-238. https://doi.org/10.2165/00007256-199826040-00002

BLAND JM, ALTMAN DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986; i:307-310.

BLAND JM, ALTMAN DG. Measuring agreement in method comparison studies. Stat Methods Med Res. 1999; 8:135-160. https://doi.org/10.1177/096228029900800204

BILLMAN GE. Aerobic exercise conditioning: a nonpharmacological antiarrhythmic intervention. J Appl Physiol. 2002; 92:446-454. https://doi.org/10.1152/japplphysiol.00874.2001

BONNEMEIER H, WIEGAND UKH, BRANDES A, KLUGE N, KATUS HA, RICHARDT G. Circadian profile of cardiac autonomic nervous modulation in healthy subjects: Differing effects of aging and gender on heart rate variability. J Cardiovasc Electr. 2003; 14(8):791-799. https://doi.org/10.1046/j.1540-8167.2003.03078.x

BRITTON A, SHIPLEY M, MALIK M, HNATKOVA K, HEMINGWAY H, MARMOT M. Changes in heart rate and heart rate variability over time in middle-aged men and women in the general population (from the Whitehall II Cohort Study). Am J Cardiol. 2007; 100:524-527. https://doi.org/10.1016/j.amjcard.2007.03.056

BROOK RD, JULIUS S. Autonomic imbalance, hypertension, and cardiovascular risk. Am J Hypertens. 2000; 13:112S-122S. https://doi.org/10.1016/S0895-7061(00)00228-4

CARTER JB, BANISTER EW, BLABER AP. Effect of endurance exercise on autonomic control of heart rate. Sports Med. 2003; 33:33-46. https://doi.org/10.2165/00007256-200333010-00003

CIPRYAN L, LITSCHMANNOVA M. Intra-day and inter-day reliability of heart rate variability measurement. J Sport Sci. 2013; 31(2):150-158. https://doi.org/10.1080/02640414.2012.721931

DAVY KP, MINICLIER NL, TAYLOR JA, STEVENSON ET, SEALS DR. Elevated heart rate variability in physically active postmenopausal women: A cardiprotective effect? Am J Physiol. 1996; 271(2 part 2):H455-H460.

DEKKER JM, CROW RS, FOLSOM AR, HANNAN PJ, LIAO D, SWENNE CA, SCHOUTEN EG. Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: The ARIC Study. Circulation. 2000; 102:1239–1244. https://doi.org/10.1161/01.CIR.102.11.1239

DE MEERSMAN RE, STEIN PK. Vagal modulation and aging. Biol Psychol. 2007; 74:165-173. https://doi.org/10.1016/j.biopsycho.2006.04.008

HEDELIN R, WIKLUND U, BJERLE P, HENRIKSSON-LARSÉN K. Pre- and post-season heart rate variability in adolescent cross-country skiers. Scand J Med Sci Sport. 2000; 10:298-303. https://doi.org/10.1034/j.1600-0838.2000.010005298.x

HJORTSKOV N, RISSÉN D, BLANGSTED AK, FALLENTIN N, LUNDBERG U, SOGAARD K. The effect of mental stress on heart rate variability and blood pressure during computer work. Eur J Appl Physiol. 2004; 92:84-89. https://doi.org/10.1007/s00421-004-1055-z

HOPKINS WG. Measures of reliability in sports medicine and science. Sports Med. 2000; 30:1-15. https://doi.org/10.2165/00007256-200030010-00001

HOPKINS WG. Calculating the reliability intraclass correlation coefficient and its confidence limits (Excel spreadsheet). newstats.org/xICC.xls. 2009.

HUIKURI HV, PIKKUJAMSA SM, AIRAKSINEN KEJ, IKAHEIMO MJ, RANTALA AO, KAUMA H, LILJA M, KESANIEMI YA. Sex-related differences in autonomic modulation of heart rate in middle-aged subjects. Circulation. 1996; 94:122-125. https://doi.org/10.1161/01.CIR.94.2.122

JENSEN-URSTAD K, STORCK N, BOUVIER F, ERICSON M, LINBLAND LE, JENSEN-URSTAD M. Heart rate variability in healthy subjects is related to age and tender. Acta Physiol Scand. 1997; 160:235-241. https://doi.org/10.1046/j.1365-201X.1997.00142.x

KOBAYASHI H. Inter- and intra-individual variations of heart rate variability in Japanese males. J Physiol Anthropol. 2007; 26:173-177. https://doi.org/10.2114/jpa2.26.173

KOSKINEN T, KÄHÖNEN M, JULA A, MATTSSON N, LAITINEN T, KELTIKANGAS-JÄRVINEN L, VIIKARI J, VÄLIMÄKI I, RÖNNEMAA T, RAITAKARI OT. Metabolic syndrome and short-term heart rate variability in young adults. Diabetic Med. 2009; 26:354-361. https://doi.org/10.1111/j.1464-5491.2009.02686.x

KUCH B, HENSE HW, SINNREICH R, KARK JD, VON ECKARDSTEIN A, SAPOZNIKOV D, BOLTE H-D. Determinants of short-period heart rate variability in the general population. Cardiology. 2001; 95:131-138. https://doi.org/10.1159/000047359

KUO TBJ, LIN T, YANG CCH, LI C, CHEN C, CHOU P. Effect of aging on gender differences in neural control of heart rate. Am J Physiol. 1999; 277:H2233–H2239.

LEICHT AS, HIRNING DA, ALLEN GD. Heart rate variability and endogenous sex hormones during the menstrual cycle in young women. Exp Physiol. 2003; 88:441-446. https://doi.org/10.1113/eph8802535

MAGAGNIN V, BASSANI T, BARI V, TURIEL M, MAESTRI R, PINNA GD, PORTA A. Non-stationarities significantly distort short-term spectral, symbolic and entropy heart rate variability indices. Physiol Meas. 2011; 32:1775-1786. https://doi.org/10.1088/0967-3334/32/11/S05

MALPAS SC. Neural influences on cardiovascular variability: possibilities and pitfalls. Am J Physiol-Heart C. 2002; 282:H6-H20. https://doi.org/10.1152/ajpheart.2002.282.1.H6

Martinmäki K, Rusko H, Kooistra L, Kettunen J, Saalasti S. Intraindividual validation of heart rate variability indexes to measure vagal effects on hearts. Am J Physiol-Heart C. 2006; 290:H640-H647. https://doi.org/10.1152/ajpheart.00054.2005

MIGLIARO ER, CONTRERAS P, BECH S, ETXAGIBEL A, CASTRO M, RICCA R, VICENTE K. Relative influence of age, resting heart rate and sedentary life style in short-term analysis of heart rate variability. Braz J Med Biol Res. 2001; 34:493-500. https://doi.org/10.1590/S0100-879X2001000400009

Nieminen T, Kähönen M, Kööbi T, Nikus K, Viik J. Heart rate variability is dependent on the level of heart rate. Am Heart J. 2007; 154:e13. https://doi.org/10.1016/j.ahj.2007.04.050

PINNA GD, MAESTRI R, TORUNSKI A, DANILOWICZ-SZYMANOWICZ L, SZWOCH M, LA ROVERE MT, RACZAK G. Heart rate variability measures: A fresh look at reliability. Clin Sci. 2007; 113:131-140. https://doi.org/10.1042/CS20070055

Ramaekers D, Ector H, AUBERT AE, RUBENS A, VAN DE WERF F. Heart rate variability and heart rate in healthy volunteers. Is the female autonomic nervous system cardioprotective? Eur Heart J. 1998; 19:1334–1341. https://doi.org/10.1053/euhj.1998.1084

Salinger J, Gwozdziewicz M Systémy používané pro vyšetření krátkodobé variability srdeční frekvence. In: Javorka K, et al. (eds) Variabilita frekvencie srdca: Mechanismy, hodnotenie, klinické využitie, OSVETA, Martin, pp 57-60, 2008.

SANDERCOCK GR, BROMLEY PD, BRODIE DA. Effects of exercise on heart rate variability: inferences from meta-analysis. Med Sci Sport Exer. 2005; 37:433-439. https://doi.org/10.1249/01.MSS.0000155388.39002.9D

STEIN PK, BARZILAY JI, DOMITROVICH PP, CHAVES PM, GOTTDIENER JS, HECKBERT SR, KRONMAL RA. The relationship of heart rate and heart rate variability to non-diabetic fasting glucose levels and the metabolic syndrome: The Cardiovascular Health Study. Diabetic Med. 2007; 24:855–863. https://doi.org/10.1111/j.1464-5491.2007.02163.x

Strauss E, SHERMAN EMS, SPREEN O. A compendium of neuropsychological test: administration, norms, and commentary. Oxford University Press, New York, 2006.

Task Force of the European Society of Cardiology, North American Society of Pacing and Electrophysiology Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation. 1996; 93:1043-65. https://doi.org/10.1161/01.CIR.93.5.1043

TSUJI H, VENDITTI FJJR., MANDERS ES, EVANS JC, LARSON MG, FELDMAN CL, LEVY D. Determinants of heart rate variability. J Am Coll Cardiol. 1996; 28(6):1539-1546. https://doi.org/10.1016/S0735-1097(96)00342-7

UMETANI K, SINGER DH, MCCRATY R. Atkinson M Twenty-four hour time domain heart rate variability and heart rate: relations to age and gender over nine decades. J Am Coll Cardiol. 1998; 31:593–601. https://doi.org/10.1016/S0735-1097(97)00554-8

YAMAMOTO Y, HUGHSON RL, PETERSON JC. Autonomic control of heart rate during exercise studied by heart rate variability spectral analysis. J Appl Physiol. 1991; 71:1136-1142. https://doi.org/10.1152/jappl.1991.71.3.1136




DOI: https://doi.org/10.4100/jhse.2014.91.08